New study shows multiple concussions affect rugby players in older age

Research involved 146 former players and showed worse cognitive function in over 75s

A new study has found that multiple concussions can have an effect on players’ cognitive functions in later life. Photo: Matthew Lewis/Getty Images

Exposure to multiple concussions may affect rugby union players’ cognitive function in older age, a new study has found.

The BRAIN Study, which involved 146 former players, found those over 75 with three or more reported concussions had significantly worse cognitive function on average than their peers who had fewer or no head injuries.

Researchers from the London School of Hygiene and Tropical Medicine (LSHTM), Queen Mary University of London and the Institute of Occupational Medicine worked with former players aged 50 and over who had represented England, Oxford University or Cambridge University.

It found overall, and in the under-75s, that those who reported three or more concussions in their career had no worse average cognitive function than those who reported suffering between zero and two concussions.


However, the study found that the 29 per cent (14 out of 48) of over-75s who reported three or more concussions in their career did have significantly worse cognitive function on average than those of the same age but with a smaller number of concussions, or none at all.

The study leads said those individuals may be at greater risk of more problems, such as memory loss, in the future.

The research team said the findings had implications for the clinical management of older former rugby players, and possibly former players in other contact sports who may be at increased risk of impaired cognitive function.

Professor Neil Pearce, from LSHTM, said: “Evidence is accumulating on the possible long-term health risks in former contact sport athletes.

“However, each sport is different and there is currently little evidence from rugby players. This study adds to this knowledge gap, and shows that playing elite rugby may affect cognitive function in older age.

“It’s important more research is conducted to confirm this, and on those who played in the early years of professional rugby.”

Participants’ cognitive function was measured using the Pre-clinical Alzheimer Cognitive Composite (PACC) score.

After adjusting for a large number of potential confounding factors including age, smoking and player playing position, participants over 75 with three or more concussions scored about two points lower on average on the PACC score.

This does not indicate disease, but may indicate an increased risk of eventually developing neurodegenerative conditions such as Alzheimer’s disease.

In total, 116 of the respondents (80 per cent) reported at least one rugby-related concussion.

Dr Simon Kemp, the Rugby Football Union’s medical services director, said: “This study, that started in 2017, adds to our developing understanding of the potential long-term consequences of head impacts and concussions.

“The agreed group of participants were aged 50-plus principally because of the greater likelihood that we might detect any neurocognitive decline if present. It is important to also conduct research with younger retired players.

“A new research programme launched with Premiership Rugby and two independent experts will run alongside the Advanced Brain Health Clinic opening in London on October 25th.

“This specialist clinical service will provide the assessment and management of retired elite male and female rugby players between the ages of 30 to 55 who have concerns over their individual brain health.”

A spokesperson for World Rugby said: “We welcome continued research into the welfare of players past, present and future in line with our stated ambition to be the most progressive sport in the world when it comes to player welfare. We do not stand still in this commitment.

“We will continue to do everything we can do, from the child and community game through to the elite level, to reassure on participation safety as well as the lifelong benefits to health and happiness from playing rugby.”

A group of former players, including 2003 Rugby World Cup winner Steve Thompson, are suing World Rugby, the Rugby Football Union and the Welsh Rugby Union over brain injuries they have suffered which they say are as a result of repeated concussions suffered during their careers.

Thompson, who is suffering from early-onset dementia, says he no longer remembers playing for England in the World Cup 18 years ago.